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Started on Friday, 29 October 2010, 09:31 PM

Completed on Tuesday, 9 November 2010, 10:12 PM
Time taken 11 days
Raw score 24/50 (48%)
Grade 48 out of a maximum of 100
Feedback Poor
Question 1
Marks: 1

Public Health Prevention Model focuses on reducing the risk of mental illness for
an entire population by providing services to high-risk groups. This applies three
levels of preventive intervention namely: primary, secondary, and tertiary
prevention.

Which of the following activities is associated with tertiary prevention?

Choose one answer.

a. lowering
incidence
b. increasing
number of
cases
- Reducing severity. Tertiary prevention attempts to reduce
severity of a mental disorder and disability through
rehabilitative activities. Lowering incidence is associated
c. reducing
with primary prevention while decreasing prevalence is
severity
associated with secondary prevention. Increasing number of
cases is incorrect as this will be the result of inadequate
preventive efforts. (Videbeck)
d. decreasing
prevalence
Correct
Marks for this submission: 1/1.
Question 2
Marks: 1

Electroconvulsive therapy (ECT) is the induction of a grand mal seizure through

the application of electrical current to the brain. The nature of this treatment is the
reason why this remains to be one of the most controversial treatments for
psychological disorders.
There are risks associated with ECT such as permanent memory loss, brain
damage, even death. But there is only one absolute contraindication for ECT.
This is:

Choose one answer.

a. congestive
heart failure
b. severe
underlying
hypertension
-The only absolute contraindication for ECT is increased
intracranial pressure. ECT is associated with a
c. increased physiological rise in cerebrospinal fluid pressure
intracranial during the treatment, resulting in increased intracranial
pressure pressure that could lead to brain stem herniation.
Recent MI, severe underlying HPN, and CHF are incorrect
(Townsend).
d. recent
myocardial
infarction
Correct
Marks for this submission: 1/1.
Question 3
Marks: 1

Major depressive disorder involves psychological, biological, and social

symptoms that impair a person's functioning ability and social interactions. A
nurse needs to have a better understanding of this condition to provide a holistic
care for the patient.

The following statements regarding depression are true, except:

Choose one answer.

a. Depression is the
result of a chemical
imbalance in the brain
often medicated by
psychosocial stressors.

b. Children do not get - Children do not get depression. Depression

depression. occurs at any age. The statement "Depression is
the result of a chemical imbalance in the brain
often medicated by psychosocial stressors" is
correct. Evidence now indicates dysregulation
of the hypothalamic-pituitary-adrenal axis in
patients with depression. Depression is a
 medical disorder that requires treatment is also
correct. Medications are now readily available to
treat depression. Depression is highly familial is
correct as well. Genetic factors are believed to
be predictors of major depression. (Antai-
Otong).
c. Depression is highly
familial.
d. Depression is a
medical disorder that
requires treatment.
Correct
Marks for this submission: 1/1.
Question 4
Marks: 1

The level of anxiety is crucial to determine appropriate interventions for the client.

What is the appropriate intervention the nurse should do for a client with panic
level of anxiety?

Choose one answer.

- Remove any dangerous things in the room. During
panic level anxiety, the client's safety is the utmost
concern. He or she cannot perceive potential harm and
may have no capacity for rational thought. Thus,
a. Remove any potentially harmful objects should be removed from the
dangerous things in patient's reach. Instructing the patient to perform deep
the room breathing exercises and discussion of the patient's
anxiety are not applicable as the client cannot take in or
process information. Reporting the behavior to the
physician is not the priority intervention for the patient
cannot be left alone at this time. (Videbeck)
b. Immediately
report the behavior
to the physician
c. Instruct the
patient to perform
deep breathing
exercises
d. Discuss with the
patient regarding
his/her anxiety
Correct
Marks for this submission: 1/1.
Question 5
Marks: 1

Extrapyramidal symptoms are reversible movement disorders induced by

neuroleptic medication.

The nurse observed Dennis, a schizophrenic patient, to have involuntary lip

smacking and tongue protrusion. She notes Dennis to be having:

Choose one answer.

a. dystonia
- Tardive dyskinesia. Tardive dyskinesia is a late-
appearing side effect of antipsychotic medications
characterized by abnormal, involuntary movements
such as lip smacking, tongue protrusion, chewing,
blinking, and grimacing, and choreiform
b. tardive dyskinesia movements of the limbs and feet. Akathisia is
characterized by restlessness and pacing. Dystonia is
characterized by spasms in discrete muscle groups.
Pseudoparkinsonism is neuroleptic-induced
parkinsonism includes shuffling gait, masklike facies,
muscle stiffness, drooling and akathisia. (Videbeck)
c.
pseudoparkinsonism

d. akathisia
Correct
Marks for this submission: 1/1.
Question 6
Marks: 1

Clients with schizophrenia usually experience delusions in the psychotic phase of

the illness. A common characteristic of schizophrenic delusions is the direct,
immediate, and total certainty with which the client holds these beliefs.

Karen, a 32-year old schizophrenic patient who was just admitted at the
psychiatric ward, claims that she is the daughter of the president of the
Philippines and threatens that she will have everybody put in jail if she is not
released from the ward immediately. The appropriate nursing intervention for
Karen who manifests delusion is:

Choose one answer.

a. Tell Karen that
what she's saying
is impossible
 b. Play along with
what Karen says

c. Give positive
feedback on
Karen's comment

- Divert Karen's attention by engaging her in group

activities. Distraction techniques such as group
d. Divert Karen's activities help the client minimize the effects of
attention by delusional thinking. A nurse should avoid openly
engaging her in confronting or arguing with the client about the
group activities delusion. Playing along or providing positive feedback
further reinforces the delusional belief and are therefore
incorrect. (Videbeck)
Correct
Marks for this submission: 1/1.
Question 7
Marks: 1

Assessment of a patient's psychosocial well-being should always include a

mental status examination. It is a must for nurses in any given clinical setting to
accurately utilize this tool and incorporate its results in the patient's nursing care
plan.

During the conduct of the mental status exam, a manic patient demonstrates
talkativeness such that topics shift from one idea to another. Nurse Gina
describes this as:

Choose one answer.

a.
perseveration

- flight of ideas. This refers to overproductive speech with

rapid shifting of topics and fragmented ideas. This is
commonly associated with mania. Word salad refers to use
of words that seem totally unrelated. Perseveration is the
b. flight of
involuntary and excessive continuation or repetition of a
ideas
single idea, response, or activity. Circumstantial thought
and speech on the other hand, is associated with excessive
and unnecessary detail relevant to a question but an answer
is eventually provided. (Stuart, Laraia)
c.
circumstantial

d. word salad
Correct
Marks for this submission: 1/1.
Question 8
Marks: 1

Major depressive disorder involves psychological, biological, and social

symptoms that impair a person's functioning ability and social interactions.

Emily, recently diagnosed with depression, seems to be absorbed in her own

world. She prefers to be alone than with the company of other people in the ward
and hardly speaks a word to the nurse assigned to her. An appropriate nursing
diagnosis for Emily is:

Choose one answer.

a. Impaired
adjustment
b. Ineffective
coping
c. Powerlessness

- Impaired social interaction. Emily's situation describes a

person who exhibits ineffective interactions with others
as manifested by preoccupation with own thoughts
and withdrawn behavior, thus the diagnosis. Impaired
d. Impaired social adjustment is irrelevant as there are no explicit behavior
interaction modifications that the individual is unwilling to modify.
Powerlessness and ineffective coping are incorrect as
there are no implicit or explicit indicators of lack of
personal control over his situation or inability to manage
internal and environmental stressors. (Carpenito-Moyet)
Correct
Marks for this submission: 1/1.
Question 9
Marks: 1

The nurse's communication is a major vehicle for helping patients and family
achieve productive emotional and behavioral outcomes.

The mother of a 19-year old girl diagnosed with leukemia is requesting the nurse
not to reveal the diagnosis to her daughter. The most therapeutic reply of the
nurse would be:

Choose one answer.

a. "Would you like
someone with the same
 condition as your
daughter to talk to you?"

b. "I think she deserves

to know what's
happening to her."
- "Let's talk about the reasons why you don't her to
c. "Let's talk about the
know of her diagnosis." It encourages
reasons why you don't
communication and exploration of feelings.
want her to know of her
Advising and giving false reassurance are
diagnosis."
nontherapeutic. (Mosby)
d. "There are scientific
breakthroughs that can
help her with her
condition."
Correct
Marks for this submission: 1/1.
Question 10
Marks: 1

Obsessive-compulsive disorder (OCD) is diagnosed only when compulsions

consume the person or he or she is compelled to act out the behaviors to a point
at which they interfere with personal, social, and occupational function.

What is the nurse's best action when he observes a client diagnosed with OCD to
be engaging in ritualistic behavior?

Choose one answer.

- Let the client finish his ritual. Allowing the client to
perform his ritual helps decrease his anxiety level.
Administering sedatives, discussing and exploring the
a. Let the client client's behavior, and instructing the client to do his ritual
finish his ritual in private do not decrease his tendency to repeat the
ritualistic behavior and would in fact, increase his anxiety
further; therefore they are incorrect. (Rinehart, Sloan,
Hurd)
b. Discuss and
explore with the
client about his
behavior
c. Instruct the
client to do his
ritual privately
d. Administer
sedatives when
 client starts the
ritual
Incorrect
Marks for this submission: 0/1.
Question 11
Marks: 1

Dissociative Identity Disorder was previously known as multiple personality

disorder. Clients have two or more distinct personalities, each with its own
behavior and attitudes.

Which of the following are signs and symptoms of dissociative identity disorder?

Choose one answer.

a. travels away from
home and takes on new
identity
b. parts of body feel
unreal, sensation of
body change,
awareness of perceptual
distortions
- sudden or dramatic behavior changes,
unremembered behaviors, changes in appearance.
Signs and symptoms of dissociative identity
disorder include unremembered disorders,
discovery of items in the client's possession for
which she cannot account, loss of time,
c. sudden or dramatic behavior characteristics that represent
behavior changes, distinctly different ages, changes in appearance
unremembered and dress, and use of different voices. Parts of
behaviors, changes in body feel unreal, sensation of body change, and
appearance awareness of perceptual distortions characterize
depersonalization disorder. Amnesia that begins
abruptly, awareness of memory loss, and
associated depression describes patients with
dissociative amnesia, while travelling away from
home and taking on new identity typifies
dissociative fugue. (Antai-Otong).
d. amnesia that begins
abruptly, awareness of
memory loss, associated
depression
Incorrect
Marks for this submission: 0/1.
Question 12
Marks: 1

Because learning is the acceptance and assimilation of information, it is

incorporated into the learner's affective, cognitive, and psychomotor domains of
knowledge and behavior.

After teaching Mr. Long the proper dietary regimen to prevent hypertension, he is
to make a food diary to ensure his adherence to the regimen. Through the food
diary, the nurse will be able to evaluate which particular learning domain?

Choose one answer.

- psychomotor domain. This is the processing and
demonstration of behaviors; the information has been
a. intellectually processed, and the individual is displaying motor
psychomotor behaviors. All these will be met through the food diary.
domain Cognitive and affective domains are incorrect since food diary
not only measures the knowledge and attitude but the motor
skill as well. Normative is irrelevant. (Townsend)
b. affective
domain
c. normative
domain
d. cognitive
domain
Incorrect
Marks for this submission: 0/1.
Question 13
Marks: 1

Paraphilia is an umbrella term for variations in sexual behavior that poses

problems to an individual.

This paraphilia refers to sexual fixation on an object to which erotic significance is

attached.

Choose one answer.

a. voyeurism

b.
exhibitionism

-fetishism, as defined above . Exhibitionism refers to

exposure of one's genitals to strangers. Frotteurism is sexual
c. fetishism fantasies involving touching and rubbing against a
nonconsenting individual. Voyeurism is sexual arousal at
secretly viewing the nude body. (Antai-Otong).
 d. frotteurism

Correct
Marks for this submission: 1/1.
Question 14
Marks: 1

Dementia is a mental disorder involving multiple cognitive deficits.

Concordia, 85 years old, is recently diagnosed with Alzheimer's Disease. She

exhibits inability to recognize or name objects despite intact sensory abilities.
This cognitive disturbance is termed:

Choose one answer.

a. aphasia
b. executive
functioning
disturbance
- Agnosia. Aphasia refers to language function
deterioration. Apraxia is impaired ability to execute motor
functions despite intact motor abilities. Executive
c. agnosia
functioning is the ability to think abstractly and to plan,
initiate, sequence, monitor, and stop complex behavior.
(Videbeck)
d. apraxia
Incorrect
Marks for this submission: 0/1.
Question 15
Marks: 1

The nurse must be aware of the therapeutic or nontherapeutic value of the

communication techniques used with the client for these serve as tools of
psychosocial intervention.

Necy, 16 years old, approached the nurse in tears. She told the nurse, "All the
other girls are making fun of me. I try to talk to them but they never listen.
Nobody wants to be my friend.". Which response by the nurse is most
therapeutic?

Choose one answer.

a. "You're feeling - "You're feeling low right now." Reflection encourages
low right now." the client to recognize and accept her own feelings.
Requesting for an explanation may be too intimidating for
the patient and may cause further anxiety. Indicating the
existence of an external source can compel a patient to
 think in a certain way. Making a stereotyped comment is
also nontherapeutic and is therefore incorrect as well.
(Townsend)
b. "What makes
you think they
don't want you to
be their friend?"
c. "Why do you
feel that way about
yourself?"
d. "Well, life is
unfair."
Incorrect
Marks for this submission: 0/1.
Question 16
Marks: 1

Increasing disorientation or confusion at night, resulting from loss of visual

accommodation and other factors, is known as sundowning syndrome. The nurse
should take special precautions to prevent falls at these times.

The following activities minimize sundowning syndrome EXCEPT:

Choose one answer.

a. minimization of
daytime sleep
b. increase in
conversations and
other social
interactions
- use of coping strategies, since this is irrelevant.
Assessing and then minimizing or eliminating any
environmental and underlying physiological causes of
c. use of coping afternoon or evening confusion or irritability such as
strategies minimization of daytime sleep, increase in
conversations and other social interactions, and
increase in mild activity would minimize sundowning
syndrome. (Stuart and Laraia).
d. increase in mild
activity
Incorrect
Marks for this submission: 0/1.
Question 17
Marks: 1
Lithium is a treatment used for bipolar disorder. Its mechanism of action is
unknown but it is thought to work in the synapses to hasten destruction of
catecholamines, inhibit neurotransmitter release, and decrease the sensitivity of
postsynaptic receptors.

Kit, diagnosed with Bipolar Type 1 is currently taking lithium carbonate. The
nurse should ensure that her diet must have adequate amount of which of the
following?

Choose one answer.

a. thiamine

b. iron
- Sodium. (Brunner and Suddarth). Iron, thiamine, and vitamin
c. sodium
C are not concerns of patients on lithium therapy.
d. ascorbic
acid
Incorrect
Marks for this submission: 0/1.
Question 18
Marks: 1

Major depressive disorder involves psychological, biological, and social

symptoms that impair a person's functioning ability and social interactions.

A withdrawn client stays in bed all day and becomes upset. The nurse's
therapeutic response would be:

Choose one answer.

a. "Just call me if
you need me,
okay?"
b. "Wait here and
I'll give you your
medications."
- "I'll just stay here with you until you feel better". This is
giving support to the client without rejecting him or
c. "I'll just stay here his behavior. Instructing the patient to stand up is not
with you until you an immediate nursing action. Giving medications will
feel better." pacify the patient but will not solve the problem. Leaving
the patient is incorrect since isolating the patient would
imply punishment. (Mosby)
d. "Stand up and
get some fresh air
outside."
Correct
Marks for this submission: 1/1.
Question 19
Marks: 1

Withdrawal is associated with neuronal excitation in the face of abrupt cessation

of alcohol. Its development is related to the amount of alcohol ingested on a daily
basis.

The most serious form of alcohol withdrawal, this is characterized by seizures,

profound confusion, and disorientation:

Choose one answer.

- Delirium tremens. Without treatment, hyperthermia,
cardiovascular collapse, and death can occur with
delirium tremens. Thus, early management of withdrawal
is crucial. Wernicke's encephalopathy is a condition
a. Delirium associated with thiamine deficiency secondary to alcohol
tremens intake. Wernicke-Korsakoff syndrome, characterized
by profound memory impairment, can result if thiamine
deficiency persists. Neuroleptic Malignant Syndrome is
irrelevant as this is a potentially life-threatening side
effect of antipsychotics. (Antai-Otong)
b. Neuroleptic
Malignant
Syndrome
c. Wernicke's
encephalopathy
d. Wernicke-
Korsakoff
syndrome
Incorrect
Marks for this submission: 0/1.
Question 20
Marks: 1

Defense mechanisms are reactions often used to protect the self. They are used
to cope with mild and moderate levels of anxiety.

Jay is impulsive and aggressive. He tries out for the school's judo team and
becomes a judo champion. Which defense mechanism is illustrated in this
situation?

Choose one answer.

a. sublimation - sublimation. This is the acceptance of a socially approved
substitute goal for a drive whose normal channel of
 expression is blocked. Jay's impulsive nature and
aggression are channeled towards a more acceptable outlet,
such as sports. In undoing, the act or communication
partially negates the previous one. In projection, the person
is attributing one's thoughts or impulses to another person.
Compensation is the process by which a person makes up
for a perceived weakness by strongly emphasizing a feature
that he or she considers more desirable. (Stuart, Laraia)
b.
compensation

c. undoing
d. projection
Incorrect
Marks for this submission: 0/1.
Question 21
Marks: 1

Mental retardation is defined as significantly subaverage intellectual functioning

that originates during the developmental period and is accompanied by deficits in
adaptive functioning. Standardized tests to measure IQ are used in the
determination of mental retardation. This is vital for nurses to consider while
providing the child's care.

Erica with IQ of 40 is categorized as:

Choose one answer.

a. mild, can learn
to read and write

b. moderate, totally
dependent
c. mild, requires
total care
- moderate, can learn activities of daily living and social
d. moderate, can skills. IQ of 40 is categorized as moderate. Thus, choices
learn activities of with mild classification are incorrect. A child classified
daily living and as moderate is trainable, can learn ADLs, and can be
social skills trained to work in a sheltered workshop. They are not
totally dependent. (Mosby)
Incorrect
Marks for this submission: 0/1.
Question 22
Marks: 1
Nurse Tin is developing specific nursing interventions for Tita, her schizophrenic
patient. She should ensure that the nursing interventions she'll include can
achieve the results specified by the goals.

To increase Tita's social interaction, Nurse Tin should best include this activity:

Choose one answer.

a. participate
in volleyball
game
- playing a card game. Card game is an activity that allows for
social interaction with limited number of individuals. A
b. playing a
volleyball game can be very stimulating and overwhelming for
card game
Tita, thus it is incorrect. Reading and watching do not
increase social interaction. (Rinehart, Sloan, Hurd)
c. watching
television in
the room
d. reading a
book
Incorrect
Marks for this submission: 0/1.
Question 23
Marks: 1

It can be difficult and frustrating to provide nursing care for survivors of violence.
The attitudes nurses bring to these situations shape their responses.

The following statements are true of abuse and its survivors, except:

Choose one answer.

a. Many women are
met with denial or
disbelief when they try
to disclose their
situation.
b. Alcohol, stress, and - Alcohol, stress, and mental illness are major causes
mental illness are of physical and verbal abuse. These are just
major causes of conditions to excuse or minimize the abuse. But
physical and verbal abuse is a learned behavior, not an uncontrollable
abuse. reaction. People are abusive because they have
acquired the belief that violence and aggression
are acceptable and effective responses to real or
imagined threats. Fortunately, because violence is a
learned behavior, abusers can benefit from
counselling and professional help to alter their
 behavior. (Stuart and Laraia). The rest are true
statements regarding abuse and its survivors.
c. In a battering
relationship, the
abuser needs no
provocation to become
violent.
d. Family violence
occurs at all levels of
society.
Incorrect
Marks for this submission: 0/1.
Question 24
Marks: 1

Erikson's Psychosocial Theory incorporates sociocultural concepts into

personality development. It provides a systematic approach and outlines specific
tasks to be completed during each stage. Nurses can plan care to assist their
clients to fulfill tasks and move on to a higher developmental level.

Marco, 40 years old, is still enjoying bachelorhood. He indulges himself in

gambling and women, though he admits that he is not satisfied with his life. His
parents who provides for him are genuinely concerned about his future once they
are gone. Marco is having problems with what stage of psychosocial
development?

Choose one answer.

a. Intimacy vs.
Isolation
- Generativity vs. Stagnation. The major task for persons in
this stage (30-65 years old) is to achieve the life goals
established for oneself while considering the welfare of
future generations. Nonachievement of this task results in
b. Generativity lack of concern for the welfare of others and total
vs. Stagnation preoccupation with the self. Identity vs. Role Confusion is
developmental task of adolescents 12-20 years old. Intimacy
vs. Isolation is for young adults 20-30 years old. Ego Integrity
vs. Despair is for late adults aged 65 years and above.
(Townsend)
c. Ego Integrity
vs. Despair
d. Identity vs.
Role Confusion

Correct
Marks for this submission: 1/1.
Question 25
Marks: 1

Alcohol can be harmless and enjoyable - even beneficial. However, it also has
the potential for abuse, but stopping the abuse is not easy.

The first signs of alcohol withdrawal first appear when?

Choose one answer.

- Several hours after the last drink. As early as 4-12
a. several hours hours of cessation of alcohol use, symptoms of
after the last drink alcohol withdrawal such as coarse hand tremors;
nausea or vomiting; tachycardia; and sweating
appear. (Townsend).
b. four to five
days after the last
drink
c. immediately
after the last drink

d. two to three
days after the last
drink
Incorrect
Marks for this submission: 0/1.
Question 26
Marks: 1

Suicide is the outcome of a person's inability to deal with catastrophic stress

resulting from biological or psychological illnesses. Accurate and complete
assessment is necessary to prevent harm done by the patient to himself/herself.

When the nurse assesses a person's nonlethal self-injury acts, he/she is

assessing the patient's:

Choose one answer.

a. suicidal
ideation

- suicidal gesture. Suicidal gestures are "attention-getting"

measures that may possibly lead to suicide attempt or
completion. Suicidal ideation includes a person's thoughts
b. suicidal
regarding suicide. Suicidal threats are verbal statements that may
gesture
declare a person's intent to commit suicide. Suicidal attempt is the
actual implementation of a self-injurious act with the express
purpose of ending the person's life. (Keltner, Schwecke, Bostrom)
 c. suicidal
threat
d. suicidal
attempt
Incorrect
Marks for this submission: 0/1.
Question 27
Marks: 1

A personality disorder is a set of patterns or traits that hinder a person's ability to

maintain meaningful relationships, feel fulfilled, and enjoy life. It is continuous
rather than episodic, and is pervasive across a wide range of circumstances in
the individual's life.

A person with histrionic personality disorder would exhibit which of the following
characteristics?

Choose one answer.

a. superior,
arrogant, indifferent
to criticisms
b. suspicious,
hypersensitive,
humorless
- extrovert, attention-seeker, melodramatic. Patients
with histrionic personality disorder dramatizes all
events and draws attention to self. They are
extroverted and draws attention to self. Superior,
c. extrovert,
arrogant, and indifferent to criticisms are descriptions for
attention-seeker,
persons with narcissistic personality disorder.
melodramatic
Suspicious, hypersensitive, and humorless fit persons
with paranoid personality disorder, while people with
schizoid personality disorder are typically introvert, cold,
and neglectful. (Keltner, Schwecke, Bostrom)
d. introvert, cold,
neglectful
Correct
Marks for this submission: 1/1.
Question 28
Marks: 1

The nurse-patient relationship has 4 phases namely: preinteraction, orientation,

working, and termination. Each particular phase has specific tasks that the nurse
should perform.
In the working phase of the nurse-patient relationship, the nurse's tasks include
the following, EXCEPT:

Choose one answer.

a. overcome
resistance barriers
b. promote patient's
development of
insight and use of
coping mechanisms

c. explore relevant
stressors
- Defining goals with the patient. This is a task in the
orientation phase of the relationship such that
said goals defined are mutual and specific.
d. defining goals with Exploring relevant stressors, overcoming resistance
the patient barriers, and promoting patient's development of
insight and use of coping mechanisms are all tasks in
the working phase of the nurse-patient relationship.
(Stuart, Laraia)
Incorrect
Marks for this submission: 0/1.
Question 29
Marks: 1

According to Maslow's theory, needs are hierarchical in nature, with the lower
level needs being critical to survival. The needs at the lower levels must be met
before the needs at the higher level can be met.

Following this theory, which of the following must be prioritized?

Choose one answer.

a.
companionship

b. achieving
prestige
c. maximizing
potential
d. avoiding harm - avoiding harm. Avoiding harm is part of the need for
safety, which is the lowest level among the choices.
Following Maslow's theory, human needs are
prioritized starting with physiologic, followed by safety,
love and belonging, self-esteem, and self-actualization
last. Among the choices, avoiding harm is highest priority,
 followed by companionship (love and belonging), achieving
prestige (self-esteem), then maximizig potential (self-
actualization). (Antai-Otong)
Correct
Marks for this submission: 1/1.
Question 30
Marks: 1

A major portion of the hyperactive child's problems relates to difficulties in

performing age-appropriate tasks. Hyperactive children are highly distractible and
have extremely limited attention spans. They often shift from one completed
activity to another. Hyperactive children have difficulty forming satisfactory
interpersonal relationships. They have difficulty complying with social norms.

Based on this assessment criteria, which of the following is the priority diagnosis
for a child with ADHD?

Choose one answer.

- Safety is the primary concern for a child with
ADHD. They experience a greater than average
a. Risk for injury related to
number of accidents, from minor mishaps to more
impulsive and acccident-
serious incidents that may lead to physical injury.
prone behavior and
Thus, safe environment should always be
inability to perceive self-
ensured. (Townsend). Low self-esteem, risk for
harm
injury, and noncompliance are not priority
diagnoses.
b. Impaired social
interaction related to
intrusive and immature
behavior
c. Low self-esteem related
to dysfunctional family
system and negative
feedback
d. Noncompliance with
task expectations related
to low frustration tolerance
and short attention span

Correct
Marks for this submission: 1/1.
Question 31
Marks: 1

Eating disorders are a significant health problem among children, adolescents,

and young women brought about by cultural and social revolution.
Anorexia Nervosa is one such eating disorder which has become increasingly
prevalent today. Which of the following statements regarding Anorexia Nervosa
is FALSE:

Choose one answer.

a. Though having weight
issues, anorectic patients
often become preoccupied
with food and eating as a
result of semistarvation.
- In females, the absence of at least two
consecutive menstrual cycles is diagnostic of
b. In females, the absence of
anorexia nervosa. Postpubertal anorectic
at least two consecutive
females who are not taking hormone
menstrual cycles is
supplements experience amenorrhea for at
diagnostic of anorexia
least 3 months. The rest are true statements
nervosa.
regarding anorexia nervosa. (Keltner,
Schweke, Bostrom)
c. The most common
premorbid personality profile
of an anorexic is that of a
perfectionistic and
introverted girl.
d. Clients with this disorder
have intense fear of gaining
weight, or becoming fat,
though underweight.
Correct
Marks for this submission: 1/1.
Question 32
Marks: 1

Neurochemical studies have consistently demonstrated alterations in the

neurotransmitter systems of the brain in people with schizophrenia.

The most prominent neurochemical theory suggests excess of what

neurotransmitter in patients with schizophrenia?

Choose one answer.

a. GABA
b.
norepinephrine

c. acetylcholine
 - Dopamine. Excess dopamine is implicated in
schizophrenia. Decreased acetylcholine is associated with
d. dopamine Alzheimer's Disease. Increased GABA function is associated
with anxiety, while norepinephrine is associated with mania.
(Videbeck)
Correct
Marks for this submission: 1/1.
Question 33
Marks: 1

Somatoform disorders are characterized as the presence of physical symptoms

that suggest a medical condition without a demonstrable organic basis.

Jun, a rookie of their school's basketball varsity team suddenly lost sensation in
his legs on the day of his first basketball game. The following day, the sensation
in his legs returned. Jun experienced what condition?

Choose one answer.

a. Somatization
disorder
- Conversion disorder. Conversion disorder involves
unexplained, usually sudden deficits in sensory and
motor function. Somatization disorder is characterized by
b. Conversion
multiple physical symptoms. Pain disorder has the primary
disorder
physical symptom of pain, while hypochondriasis is
preoccupation with the fear that one has a serious
disease. (Videbeck)
c.
Hypochondriasis

d. Pain disorder

Incorrect
Marks for this submission: 0/1.
Question 34
Marks: 1

Defense mechanisms are methods of attempting to protect the self and cope with
basic drives or emotionally painful thoughts, feelings, or events.

Which defense mechanism is typical of patients with borderline personality

disorder to avoid the pain and feelings associated with past abuse and current
situations involving threat of rejection or abandonment? He/she therefore views
self and others as either all good or all bad.

Choose one answer.

 a. projection

b.
rationalization

- splitting. Splitting is defined as the inability to view both self

and others as having both good and bad qualities. Projection
is the unconscious blaming of unacceptable inclinations or
c. splitting thoughts on an external object. Rationalization is excusing
own behavior to avoid guilt, and other negative feelings.
Sublimation is substituting a socially acceptable activity for
an impulse that is acceptable. (Keltner, Schwecke, Bostrom)
d. sublimation

Incorrect
Marks for this submission: 0/1.
Question 35
Marks: 1

Extrapyramidal symptoms are reversible movement disorders induced by

neuroleptic medication. One common extrapyramidal symptom is
pseudoparkinsonism.

Eddie, who had just had his antipsychotic medication dosage increased three
days ago, demonstrates shuffling gait, muscle stiffness, and akinesia. The nurse
anticipates which of the following medications to be ordered by the physician?

Choose one answer.

- Biperiden (Akineton). Biperiden is an
antiparkinsonism drug. Chlorpromazine and
a. Biperiden
Risperidone are antipsychotic medications.
(Akineton)
Carbamazepine is an anticonvulsant also used as mood
stabilizer. (Videbeck)
b. Carbamazepine
(Tegretol)
c. Risperidone
(Risperdal)
d. Chlorpromazine
(Thorazine)
Correct
Marks for this submission: 1/1.
Question 36
Marks: 1

Medication management greatly affects the treatment outcomes of patients with

mental disorders. Nurses should be able to understand how these drugs work;
their side effects, contraindications and interactions; and the nursing
interventions required to help clients manage medication regimens.

Nursing care of clients receiving antipsychotic agents include the following,

except:

Choose one answer.

a. Instruct client to
avoid exposure to
direct sunlight.
- maintain suicide precautions. Side effects of
antipsychotic drugs include orthostatic hypotension,
extrapyramidal symptoms, and photophobia. Thus,
monitoring blood pressure in standing and supine
b. Maintain suicide
positions, monitoring extrapyramidal symptoms, and
precautions.
instructing client to avoid exposure to direct sunlight
apply. Suicide precautions are observed rather in
clients receiving antidepressants, especially as
depression begins to lift. (Mosby)
c. Monitor
extrapyramidal
symptoms.
d. Monitor blood
pressure in standing
and supine positions.

Incorrect
Marks for this submission: 0/1.
Question 37
Marks: 1

A major component of the mental status examination is thought content and

processes. Thought content refers to the specific meaning expressed in the
patient's communication.

All describe thought content, except:

Choose one answer.

a. phobia
b. - Hallucination. Delusion, obsession, and phobia are
hallucination descriptors of thought content. Hallucination on the other
hand, refers to thought perception. (Stuart, Laraia)
c. obsession

d. delusion
Incorrect
Marks for this submission: 0/1.
Question 38
Marks: 1

Alcohol remains the most used and abused substance in all age groups. People
who are alcohol dependent have often been viewed as individuals who easily
succumb to the escape provided by alcohol.

Psychoanalytic theory describes people with alcohol dependency as having

unresolved problems in this particular psychosexual stage:

Choose one answer.

a.
genital

b.
phallic

c. anal

- oral. Drinking alcohol is thought to be an attempt to satisfy

d. oral unconscious oral needs. Anal, phallic, and genital phases are
incorrect.(Keltner, Schwecke, Bostrom)
Incorrect
Marks for this submission: 0/1.
Question 39
Marks: 1

Electroconvulsive therapy (ECT) is a modality used to treat depression in select

groups. Nurses have responsibilities before and after the ECT procedure to
promote patient safety while undergoing the treatment.

A 35-year-old male client has just awakened from his first ECT treatment. The
initial nursing intervention would be to:

Choose one answer.

a. Prepare the client
for his meal
b. Check the VS
every 5 minutes
until he is fully
awake
c. Orient the client - Orientation. Confusion and temporary memory loss
to time and place are commonly experienced post-ECT. Thus,
and tell him that he orientation to time, place, and situation is important. VS
 taking every 5 minutes is not necessary. Preparing the
just had a treatment client for his meal can be done but is not the initial
nursing intervention. Returning the patient to the ward
cannot be done right after an ECT treatment. (Mosby)
d. Bring him back to
his ward as soon as
he wakes up
Incorrect
Marks for this submission: 0/1.
Question 40
Marks: 1

Nurses regardless of clinical setting, encounter anxious clients in a variety of

situations. The nurse must assess the person's anxiety level to determine
interventions likely to be applicable.

At what particular level of anxiety can teaching be very effective?

Choose one answer.

a. severe

b. panic
- Mild. People with mild anxiety can learn and solve problems
and are eager for information, thus teaching can be very
effective. People with moderate anxiety can have difficulty
c. mild
concentrating over time thus can have problems learning. Clients
in severe and panic level of anxiety can no longer take in
information. (Videbeck)
d.
moderate

Correct
Marks for this submission: 1/1.
Question 41
Marks: 1

The termination phase is one of the most difficult but critical phases of the
therapeutic nurse-patient relationship. This is greatly influenced by a patient's
readiness for termination, thus the need to identify indicators.

Criteria in determining patient readiness for termination includes all, but one:

Choose one answer.

a. changing the topic - changing the topic whenever the subject of
whenever the subject termination is brought up. Successful termination
of termination is requires that the patient work through feelings
 related to separation. The patient should be
allowed to feel the effects of the anticipated loss
and express feelings generated by the impending
brought up separation. Experiencing relief from presenting
problem, improvement in functioning, and using
adaptive coping responses are criteria in determining
readiness for termination. (Stuart, Laraia)
b. using adaptive
coping responses
c. experiencing relief
from presenting
problem
d. improvement in
functioning
Incorrect
Marks for this submission: 0/1.
Question 42
Marks: 1

Clients presenting with substance-related disorders are likely to demonstrate

physical signs of abuse.

A patient who takes marijuana will probably exhibit the following signs and
symptoms:

Choose one answer.

a. analgesia, sedation,
psychomotor
retardation,
constricted pupils
- euphoria, spatial perception and time distortion, dry
mouth, blood shot eyes. These signs and symptoms
are typical of marijuana abuse. Alertness,
palpitations, dilated pupils, and tremors result from
b. euphoria, spatial
taking CNS stimulants such as cocaine. Analgesia,
perception and time
sedation, psychomotor retardation, and
distortion, dry mouth,
constricted pupils can be seen in people taking
blood shot eyes
opiates which are CNS depressants. Stimulation,
enhanced performance and alertness, and
appetite suppression are present in people taking
nicotine, which is present in cigarettes. (Antai-Otong).
c. alertness,
palpitations, dilated
pupils, tremors
d. stimulation,
 enhanced
performance and
alertness, appetite
suppression
Correct
Marks for this submission: 1/1.
Question 43
Marks: 1

Suicidal thoughts are common in people with mood disorders. Most people with
suicidal ideation send either direct or indirect signals to others about their intent
to harm themselves. A nurse never ignores any hint of suicidal ideation
regardless of how trivial or subtle it seems and the client's intent or emotional
status.

On his 6th day at the psychiatric ward, a male client diagnosed with bipolar
disorder tells the nurse, "I am tired of this. I want to end my misery." The nurse's
best reply would be:

Choose one answer.

a. "You're just
tired. Let's talk
about something
else."
b. "Life is not as
bad as you think
it is."
- "Are you saying that you're going to kill yourself?". This is
the client's cry for help to prevent suicide. Thus, the nurse
c. "Are you should respond to this call, making sure that he/she
saying that you're focuses on the client's feelings and does not attempt
going to kill to challenge or deny the thought. Changing the topic of
yourself?" the conversation ignores the client's call for help. Telling
cliches negates the client's feelings and is already
interpreting the situation. (Mosby)
d. "I know you
don't really mean
that."
Correct
Marks for this submission: 1/1.
Question 44
Marks: 1

For treatments to be effective in achieving a certain goal, they should be age-

specific.
The therapy especially beneficial for preschool children who are victims of sexual
abuse is:

Choose one answer.

a. group
therapy
b.
psychodrama

c. family
therapy
- play therapy. Play therapy is normal and fun for children.
Beneficial outcomes include trust in others and
d. play therapy emotional release. Psychodrama, group therapy, and family
therapy are not appropriate for the particular age group.
(Stuart and Laraia).
Correct
Marks for this submission: 1/1.
Question 45
Marks: 1

Patients being treated for life-threatening illnesses show varying emotions. But
not only do patients suffer but their families and significant others as well.

The spouse of your patient with cancer looks tired and worn out. She is
constantly asking for nurses and complains that "no one is available to assist
them". She might be suffering from a condition called:

Choose one answer.

a. spiritual
distress
b. sleep
deprivation

c.
anticipatory
grief
d. caregiver - Caregiver stress. The situation fits the definition of caregiver
stress stress which is the emotional and physical strain
experienced by a person caring for someone with a
chronic debilitating disease or life-threatening condition.
(Stuart and Laraia). Spiritual distress cannot be the answer
since there were no indicators expressing doubts and concerns
involving religious faith or practice. Anticipatory grief is
incorrect as there were no signs stating of impending loss.
Sleep deprivation is also incorrect since no statements stating
 that the spouse's stress was due to lack of sleep. (Carpenito-
Moyet)
Incorrect
Marks for this submission: 0/1.
Question 46
Marks: 1

The assault cycle has five stages of a predictable pattern or chain of aggressive
responses to emotional or physical stress. The interventions vary according to
phase but share one goal which is to strengthen patient's control of feelings and
compulses.

Which of the following interventions is NOT applicable in the escalation phase of

the assault cycle?

Choose one answer.

a. Make a "show of
force" to the client

b. Take control of
the situation
- Discuss alternative solutions to the situation and
c. Discuss
feelings. The rest are appropriate nursing interventions in
alternative
the escalation phase. Discussion of alternative solutions
solutions to the
to the situation and feelings is more applicable in the
situation and
post-crisis depression phase. (Keltner, Schwecke,
feelings
Bostrom)
d. Instruct client to
take a "time-out"

Correct
Marks for this submission: 1/1.
Question 47
Marks: 1

There are various theories explaining depression as a phenomena. One such

theory is the cognitive-behavioral theory as explained by Beck which states that
depression in any form, displays the negative cognitive triad.

Which of the following is not a part of the negative cognitive triad?

Choose one answer.

a. negative - negative view of others. Depressed patients display
view of negative view of self, the world, and of the future. He/She
others sees oneself as defective, inadequate, and worthless. For
him/her, the world is experienced as a demanding place. Also,
 he/she anticipates hardship, suffering, and failure in the future.
(Antai-Otong). Negative view of others does not belong to the
group.
b. negative
view of the
future
c. negative
view of self

d. negative
view of the
world
Incorrect
Marks for this submission: 0/1.
Question 48
Marks: 1

Freud conceptualized personality structure as having three components: id, ego,

and superego.

At what developmental stage does superego develop?

Choose one answer.

- preschool. It is in the preschool stage where the superego, or
a.
conscience develops. Infants are born with the id, toddlers
preschool
develop ego, and finally preschoolers develop their
conscience. (Videbeck)
b. infant
c. toddler

d. school
age
Incorrect
Marks for this submission: 0/1.
Question 49
Marks: 1

Therapeutic communication techniques are used to facilitate the interaction and

enhance communication between client and nurse.

During the working phase of the relationship, Nurse Carlo asked his patient, "Of
all the concerns you've mentioned, which worries you the most?" Which
therapeutic communication technique did Nurse Carlo use?

Choose one answer.

 - Focusing. The nurse encourages the client to concentrate his
or her energies on a single point, which prevents factors or
problems from overwhelming the client. This is the correct
answer. Exploring is delving further into a subject or idea. There
a. Focusing was no particular topic explored, thus this is incorrect. General
leads is giving encouragement to continue while reflecting is
directing client actions, thoughts, and feelings back to client.
There were no indicators to utilize general leads or reflecting in
the situation; therefore, both are also incorrect. (Videbeck)
b.
Reflecting

c. General
leads
d. Exploring

Correct
Marks for this submission: 1/1.
Question 50
Marks: 1

Nurses are tasked with the promotion of healthy outcomes for people in times of
crisis. This is achieved through crisis intervention, a brief and focused strategy
that aids people to cope adaptively with stressful events.

The nurse should know that the main goal of nursing care for a client in crisis
would be to:

Choose one answer.

a. schedule follow-up
counselling for the
client
- Restore client's physiologic equilibrium. Crisis
intervention is a short-term therapy which aims to
return clients to their precrisis state. Developing the
b. restore client's client's insight to the problem and assisting client to
physiologic utilize adaptive coping mechanisms immediately are
equilibrium long-term outcomes which may not be readily
achievable during crisis intervention. Scheduling for
follow-up counselling is not a goal of crisis intervention.
(Mosby)
c. assist client to
utilize adaptive
coping mechanisms
immediately
 d. develop the
client's insight to the
problem
Incorrect
Marks for this submission: 0/1.
Marks: 1